Following recommendations made by the Clinical Assessment Workgroup after over two years of work, the University of Washington School of Medicine will be transitioning to a competency-based medical education (CBME) model, including pass/fail grading for required Patient Care core clerkships, beginning in Spring 2026. The new Competency Mapping and Programmatic Assessment System (COMPASS) framework aims to address concerns about inequities within the current tiered grading system and to better align educational practices with patient needs and competencies in ongoing medical education. Look for the compass icon to identify changes associated with this new program of assessment:
In preparation for this significant shift, we will be piloting workplace-based assessments (WBAs) during the 2025-2026 academic year. This pilot will focus on required Patient Care core clerkships and will help us understand how WBAs can be effectively integrated into our current curriculum. Input and collaboration from faculty, students, and staff will be invaluable as we refine our approach ahead of the full implementation.
WBA Pilot
WBAs are brief, formative assessments completed by a preceptor after a clinical encounter that rate a student’s performance and provide feedback for that specific encounter. Many clerkships already provide feedback similar to WBAs that are not currently recorded or systematically tracked, making it difficult to gauge students’ progress toward achieving competency in each of the School’s 32 medical education program objectives (MEPOs).
WBA Toolkit for Students
CLICK HEREWBA Toolkit for Clerkships
CLICK HEREAdditional Resources
CLICK HERE
Beginning in Spring 2025, all students enrolled in the six required Patient Care core clerkships (Family Medicine, Internal Medicine, Psychiatry, Obstetrics & Gynecology, Surgery, and Pediatrics), including WRITE clerkships, will be required to complete additional WBA requirements. Students will need to submit WBAs for the following six required activities:
- Gather a history
- Perform a physical examination
- Prioritize a differential diagnosis following a clinical encounter
- Recommend appropriate diagnostic and screening tests
- Interpret common diagnostic and screening tests
- Provide an oral presentation of a clinical encounter
Preceptors will be asked to provide brief feedback (1-2 sentences) on what the student did well and what they can do to improve. They will also provide a rating for the encounter utilizing the following entrustment scale:
- “I stepped in and did it, they observed”
- “I talked them through it”
- “They mostly did it, I directed them from time to time”
- “I was available just in case and I checked their work”
For 3-week and 6-week clerkships: Students will need to complete at least two WBAs per week and at least one assessment for each of the six required activities over the course of the clerkship.
For 12-week clerkships: Students will need to complete at least two WBAs per week and at least two assessments for each of the six required activities over the course of the clerkship.
Completion of new WBA requirements will add a bonus of up to 2% to the final clinical grade in all required Patient Care core clerkships, not to exceed 100%. Students will receive credit for all submitted assessments as a proportion of the total number/type of WBAs required. For each WBA submitted (up to a maximum of 2/week), students will earn 1/6 of 1% for 3-week clerkships, 1/12 of 1% for 6-week clerkships, or 1/24 of 1% for 12-week clerkships. For each activity submitted, students will earn 1/6 of 1% for 3-week and 6-week clerkships (up to a maximum of 1/activity) or 1/12 of 1% for 12-week clerkships (up to a maximum of 2/activity).
Completing WBAs
To complete a WBA, a student requests to be assessed on one of the six required activities for a clinical encounter. During the activity, the preceptor observes the student’s actions, decisions, and interactions. Afterward, the student reflects on their performance and discusses it with the preceptor, who provides feedback and helps set measurable goals for development.
During the pilot year, UWSOM will be utilizing Qualtrics to collect WBA data with the following functionality:
- The assessment form, accessible through the student’s unique link or QR code, can be completed by either the student or the preceptor.
- Both the student and preceptor will receive a copy of the assessment after it is submitted.
- Preceptors will be prompted to review submitted assessments for accuracy and can make changes, if needed. Preceptors can also report assessments submitted in error.
- Students can track their progress toward achieving WBA requirements and review feedback on their dashboard.
- Clerkships can access WBA completion data for students currently rotating in their department to track students’ progress and determine final grades. Clerkships will not have access to students’ WBA data from other departments.
Practice submitting a sample WBA form to familiarize yourself with the process.
FAQs
WBAs are brief, formative assessments completed by a preceptor after a clinical encounter that rate a student’s performance and provide feedback for that specific encounter. Some examples of WBAs include:
• Entrustable professional activities (EPAs)
• Mini-clinical evaluation exercise (mini-CEX)
• Direct observation of procedural skill (DOPS)
• Clinical encounter card (CEC)
• Acute case assessment tool (ACAT)
• Consultation observation tool (COT)
• Observed history & physical (H&P)
• Case-based discussions (e.g., Aquifer cases)
• Direct observation, assessment, and feedback
In practice, a WBA might involve tasks such as conducting a patient interview, performing a physical examination, or managing a specific clinical procedure. For example, a student might be assessed on their ability to conduct a thorough history and physical exam on a patient. The preceptor would observe the student during this process, assessing their communication skills, clinical reasoning, and professionalism. If the student meets the established criteria, the preceptor would then “entrust” them to perform this activity with less supervision in future clinical settings, thereby confirming their competence in that area.
Your unique form link and QR code will be emailed to you before Transition to Clerkships. It is also available at any time on the Student Performance Dashboard.
Beginning Spring 2025, new WBA requirements will only be required in the six required Patient Care core clerkships (Family Medicine, Internal Medicine, Psychiatry, Obstetrics & Gynecology, Surgery, and Pediatrics), including WRITE clerkships.
You will receive credit for all submitted assessments as a proportion of the total number/type of WBAs required.
1% of the bonus is for submitting the correct number of WBAs. For each WBA submitted (up to a maximum of up to 2/week) students will earn 1/6 of 1% for 3-week clerkships, 1/12 of 1% for 6-week clerkships, or 1/24 of 1% for 12-week clerkships.
The other 1% of the bonus is for submitting across all required activities. For each activity submitted, students will earn 1/6 of 1% for 3-week and 6-week clerkships (up to a maximum of 1/activity) or 1/12 of 1% for 12-week clerkships (up to a maximum of 2/activity).
Example: You complete 2 WBAs/week every week of a 6-week clerkship and obtain at least one assessment for 4 of the 6 required activities. You will receive a 1.67% (1/12 * 12 + 1/6 * 4) bonus to your clinical grade in that clerkship, not to exceed 100%.
Example: You complete 2 WBAs/week for 3 weeks of a 6-week clerkship and 1 WBA/week for the other 3 weeks and obtain at least one assessment for 5 of the 6 required activities. You will receive a 1.58% (1/12 * 9 + 1/6 * 5) bonus to your clinical grade in that clerkship, not to exceed 100%.
If you are having difficulty finding opportunities to be assessed for a particular activity or finding preceptors willing to assess you, please contact the Clerkship Director.
WBAs are most effective when focused around a single activity, and WBA requirements have been designed with this in mind. Before requesting multiple WBAs, talk to your preceptor about whether they feel the activities can be adequately assessed in a single encounter.
If you are having difficulty finding opportunities to be assessed for a particular activity or finding preceptors willing to assess you, please contact the Clerkship Director.
You will receive credit toward the WBA requirement regardless of whether a preceptor confirms the assessment.
If you are having difficulty getting an assessment confirmed by a preceptor who assessed you, please contact the Clerkship Director.
WBAs are intended as opportunities for formative assessment. However, preceptors will receive copies of WBAs they submit and may reference them when providing comments to the Clerkship Director about your performance.
More information about CBME, the Clinical Assessment Workgroup, and changes coming to UWSOM in Spring 2026 can be found on the Clinical Assessment Workgroup page. To sign up for notifications about the Clinical Assessment Workgroup, email Mary Sargent.